婴儿细胞色素P450氧化还原酶缺陷症1例

Cytochrome P450 oxidoreductase deficiency in an infant

本文报道1例细胞色素P450氧化还原酶缺陷症(cytochrome P450 oxidoreductase deficiency,PORD)患儿的诊治过程。患儿,男,38日龄,生后10 d出现鼻塞、吃奶费力、体重增长不满意,收入山东大学附属儿童医院,体格检查示:额缝早闭、手足畸形,外生殖器未见异常;实验室检查:血清促肾上腺皮质激素水平轻度升高、皮质醇水平降低。全外显子组测序结果示,患儿POR基因存在c.1370G>A(p.R457H)纯合变异,确诊为PORD。本例提示骨骼畸形合并外生殖器畸形和/或肾上腺皮质激素异常是PORD重要的诊断线索。

This study reported the diagnosis and treatment of cytochrome P450 oxidoreductase deficiency(PORD)in a male infant.The patient was admitted to Children's Hospital Affiliated to Shandong University at the age of 38 days due to nasal obstruction and feeding difficulties presented at 10 d after birth,as well as less weight gain.Physical examination showed craniosynostoses,hand and foot deformities,and normal external genitalia.Laboratory examination revealed mildly elevated serum adrenocorticotrophic hormone and decreased level of baseline cortisol.A homozygous mutation of c.1370G>A(p.R457H)in POR gene was detected by whole-exome sequencing,which confirmed the diagnosis of PORD.Skeletal deformities complicated by external genital malformations and/or adrenocortical hormone abnormalities are important diagnostic indicators for PORD.